Muscle Hernia or Varicose Veins?

Muscle herniations of the legs frequently are confused with varicose veins. Patients may present with bulging along the outer part of the shin, that looks like a varicose vein. It may or may not be painful. It goes away with flexing the foot (pointing your toes to your head).  But, to experienced vein care specialists, it is clearly a muscle herniation.

A Muscle herniation is a focal protrusion of muscle tissue through a defect in the deep fascial layer. Anterior tibial muscle is the most commonly affected muscle of the lower extremities because its fascia is the most vulnerable to trauma. Clinically it is characterized by asymptomatic or painful, skin-coloured, soft, subcutaneous nodules of various size depending on the position. The diagnosis is usually made clinically based on its typical manifestations, but ultrasonographic examination is useful for detecting the fascial defect and excluding other conditions caused by soft tissue tumours such as lipomas, angiolipomas, fibromas, schwannomas or varicosities.

Usually, surgical treatment is not needed, but may be necessary for increasingly painful hernias.

At La Jolla Vein Care, we frequently see muscle herniations that are confused with varicose veins. Using ultrasound technology and a clinical examination, we can make the accurate diagnosis.

World Thrombosis Day

Venous thrombosis is an extremely important condition, that we take very seriously at La Jolla Vein Care. Since we deal with veins, we frequently diagnose this condition  in our office.  This condition always requires attentions, as consequences can be severe and life-threatening in some cases.  The following about World Thrombosis Day, which is a movement to increase public and professional education about blood clots,  is reprinted from worldthrombosis.org.

World Thrombosis Day (WTD) is one day – October 13 – around the world dedicated to focusing attention on the often overlooked and misunderstood disease burden caused by  thrombosis globally…but it is not a one-time observance.

Thrombosis refers to a blood clot that forms in your artery or vein. It is the one disorder that causes the world’s top three cardiovascular killers: heart attack, stroke and venous thromboembolism (VTE) – a blood clot mostly in the leg or lungs. While most people are aware of heart attack and stroke, fewer people know about VTE. That’s why VTE is our initial focus for WTD. 

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La Jolla Vein Care supports World Thrombosis Day

The World Health Assembly has set a global target of reducing premature deaths from non-infectious disease, including cardiovascular disease, by 25 percent by 2025. To meet this goal, we must reduce thrombosis.

 

Inherited Risk of Deep Venous Thrombosis (DVT)

The Factor V Leiden mutation is one of the most common inherited genetic mutations, causing blood clotting disorders. It is found in 4% to 6% of the U.S. population.

If someone has one copy of this genetic mutation (heterozygous), they are considered a carrier of the mutation.  A carrier has an approximate 3 to 6 fold increased risk of venous thromboembolism.  If a person carries two copies of the genetic mutation (homozygous) their risk of a blood clot is much higher, and many of these patients will be on lifelong blood thinners. This risk is increased when exposed to other risk factors such as pregnancy, oral contraceptives, immobility, and surgery.  If you are Factor V Leiden, the doctor may recommend a blood thinner during varicose vein treatment. It is important to talk with your doctor about your history or family history of blood clotting disorders, to better reduce your risk of a blood clot when undergoing any type of procedure or surgery.

 

Before and After Photo: Varicose Veins

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Varicose veins, of any size can be successfully removed without surgery. There are a number of non-invasive treatment options to remove them without surgery. See more before and after pictures of La Jolla Vein Care treatments, on the ‘results’ page.

Varicose veins, which are the bulging, twisted veins just beneath the surface of the skin, can cause symptoms such as leg heaviness, aching, tiredness, swelling, fatigue, throbbing, burning, restless legs and night cramps.  Fortunately, there are a number of non-invasive treatment options to remove them without surgery. The doctors at La Jolla Vein Care have specialized in non-surgical vein removal for several years and thousands of non-surgical vein procedures have been successfully performed at La Jolla Vein Care.  See more before and after pictures, on the ‘results’ page.

Complications of Untreated Varicose Veins #1: Phlebitis

What Possible Complications Can Occur From Untreated Varicose Veins?

Over time, complications can develop from untreated veins. These include:

  • Superficial phlebitis

    stp

    A superficial thrombophlebitis (also known as STP) refers to a blood clot that has formed within the vein causing it to become painful and inflamed. The overlying skin becomes red, hot and painful to touch. The blood clot forms as a complication of varicose veins, because the blood is not circulating well in varicose veins.

  • Skin discoloration and eczema around the ankle
  • Skin sores or ulcers usually near the ankle
  • Burst or hemorrhaged vein
  • Chronic venous insufficiency
  • Infection of the skin, or cellulitis

This blog post will discuss phlebitis. Phlebitis refers to the painful swelling and inflammation within a vein, usually a varicose vein.  A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. A phlebitis is common with varicose veins, and thrombophlebitis less common but still a potential complication from untreated varicose veins.  A thrombophlebitis refers to a blood clot that has formed within the vein causing it to become painful and inflamed. The overlying skin becomes red, hot and painful to touch.

The blood clot forms because the blood is not circulating well in varicose veins. The blood is stagnant in varicose veins and is more likely to form clots. When blood clots are formed within varicose veins, this is called a superficial thrombophlebitis (since varicose veins sit near the skin surface).  This is often referred to as an STP.

The following symptoms are often associated with thrombophlebitis:

  • Inflammation (swelling) in the part of the body affected
  • Pain in the part of the body affected
  • skin redness (not always present)
  • Warmth and tenderness over the vein

Thrombophlebitis of varicose veins can be avoided by wearing compression stockings daily (prevents pooling of blood), leg elevation, staying active and treating the varicose veins.  If you think you have phlebitis, you should see a doctor. An ultrasound examination is may be necessary.

Before and After: Varicose Veins

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Before and After Photo: This is a before and after picture of varicose veins that were removed without surgery at La Jolla Vein Care. Modern varicose vein treatments no longer require surgical removal. Please see our photo gallery for more before and after pictures (‘Results’ page) of varicose veins at http://lajollaveincare.com/results/ or click on the ‘Treatments’ page to learn more about our treatments.

Before and After Photo: This is a before and after picture of varicose veins that were removed without surgery at La Jolla Vein Care. Modern varicose vein treatments no longer require surgical removal. Please see our photo gallery for more before and after pictures of varicose veins, spider veins and venous leg ulcers on our ‘Results’ page  or click on the ‘Treatments’ page to learn more about our treatments.

Dr. Fronek Featured in National Vein Magazine

Past ACP President and La Jolla Vein Care’s Dr. Helane Fronek, MD, FACPh, FACP was featured in this summer’s Vein Magazine. The 5-page interview with Dr. Fronek discusses topics such as her career and perspectives in the fields of venous disease and medicine. She is described as:

‘Professionally, Dr. Froenk sees patients at La Jolla Vein Care, educates medical students as an assistant clinical professor at the UC San Diego School of Medicien, is the author of the Fundamentals of Phlebology, is a past President of the American College of Phlebology (ACP), is the first recipient of the ACP’s Leadership Award and is recognized as an Honorary Memeber of the organization……..she is also a blogger on The Huffington Post and has recently added Life Coach to her distinguished resume…’

Vein magazine

Past ACP President and La Jolla Vein Care’s Dr. Helane Fronek, MD, FACPh, FACP was featured in this summer’s Vein Magazine. The 5-page interview with Dr. Fronek discusses topics such as her career and perspectives in the fields of venous disease and medicine.

Dr. Fronek

Dr. Helane Fronek, MD, FACPh, FACP is a Past ACP President, author of the Fundamentals of Phlebology, Assistant Clinical Professor at UCSD School of Medicine and presently sees patients at La Jolla Vein Care, located at the Scripps Memorial Campus.

La Jolla Vein Care is grateful to have such a talented doctor on our staff. You can read Dr. Fronek’s blog  at helanefronekmd.wordpress.com.

 

DVT (Deep Venous Thrombosis) Afflicts American Idol

On Friday, former American Idol contestant Michael Johns suddenly died at age 35, allegedly from a blood clot that formed in his ankle. No official details have been released, but TMZ is reporting that Michael Johns twisted his ankle.  Other celebrities who have made relatively recent headlines for suffering from DVT include Real Housewives of Atlanta star, Nene Leakes, and Tennis Star Serena Williams.  Other well known figures such as

Richard Nixon, Dan Quayle, Dick Cheney and David Bloom have all suffered a potentially fatal deep venous thrombosis (DVT).

Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow and cause swelling and pain. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart, or other area, leading to severe damage.

Blood clots may form when something slows or changes the flow of blood in the veins. Risk factors include:

  • Bedrest
  • Cigarette smoking
  • Family history of blood clots
  • Fractures in the pelvis or legs
  • Giving birth within the last 3 months
  • Heart Failure
  • Obesity
  • Recent surgery (especially hip, knee, or female pelvic surgery)
  • Too many blood cells being made by the bone marrow

You’re also more likely to develop DVT if you have any of the following conditions:

  • Blood that is more likely to clot (hypercoagulability)
  • Cancer
  • Taking estrogens or birth control pills.
  • Long airplane flights: London’s Heathrow Airport reports one passenger death a month from DVT. One nearby hospital recorded thirty passenger deaths from DVT in the past three years including a 28-year-old man. To reduce the risk of DVT during air travel,  passengers are advised to wear compression stockings on flights, frequent moving aroudnt he cabinand pumping the calf muscles, leg elevation and avoidance of sedentary positions for long periods of time without moving.

If you might have a DVT, it is important to see a doctor. Signs of a DVT may be sudden leg pain and swelling. It can be diagnosed by ultrasound imaging. See our other blogs about ultrasound imaging and DVT detection.

What is a Superficial Thrombophlebitis?

A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. There are two main types of thrombophlebitits: deep venous thrombosis (affects deeper, larger veins) and superficial thrombophlebitis (affects veins near the skin surface).  This is often referred to as an STP.

The following symptoms are often associated with thrombophlebitis:

  • Inflammation (swelling) in the part of the body affected
  • Pain in the part of the body affected
  • skin redness (not always present)
  • Warmth and tenderness over the vein

The following increase your chances for thrombophlebitis:

  • Being hospitalized for a major surgery or with a major illness
  • Disorders that make you more likely to develop blood clots
  • Sitting for a long period of time (such as on a long airplane trip)
  • Varicose veins

An STP is common complication of varicose veins. But, it can also indicate an underlying problem with blood clotting.  In some cases, there may also be a concurrent blood clot in other veins, such as the deep veins (DVT) which can be serious. For this reason, a duplex ultrasound examination is used to look at the deep veins and other veins not visible to the naked eye for the presence of blood clots.

If it is localized to a small surface vein, it can usually be treated with  aspirin or other anti-inflammatory medication to reduce pain and inflammation, compression stockings, and cold/warm packs to also reduce inflammation and discomfort. The discomfort is usually improved within 6 weeks but it can take a few months to resolve.

If the superficial thrombophlebitis is extensive or if it appears to be ‘migrating’ up the leg, a blood thinner may be necessary.  You should see your doctor if you develop an STP.

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A thrombophlebitis is swelling and inflammation of a vein caused by a blood clot. This patient has a superficial thrombophlebitis, which is a blood clot in the superficial, surface veins. You can see redness in the inner thigh of this patient, which is caused by the inflammation and swelling from the blood clot. It can be very painful. You should see your doctor for superficial thrombophlebitis.

 

Have Tea with the Vein MD August 11th

La Jolla Vein Care is announcing their new ‘Tea with the MD’ series of educational seminars for patients to learn more about varicose veins, what causes them, what’s new in treatment, etc.  Dr. Bunke will be kicking off the first seminar Monday, August 11th.  This is an opportunity to ask the doctor all of your vein related questions in a small group.  Those who are interested are asked to call 858-550-0330 to RSVP as space is limited to keep the discussions quaint.  Light snacks/lunch will be served and parking will be validated. Tea-With-MD-Ad-print